Trichoscopic Signs in Systemic Lupus Erythematosus: A Comparative Study with 109 Patients and 305 Healthy Controls

The study compared trichoscopic features of 109 systemic lupus erythematosus (SLE) patients without chronic cutaneous scalp lesions to 305 healthy controls, finding that hair shaft changes were significantly more common in SLE patients and correlated with higher SLE Disease Activity Index 2000 (SLEDAI-2K) scores. Common trichoscopic signs in SLE patients included prominent and thick arborizing blood vessels, black dots, brown scattered pigmentation, and blue-grey speckled pigmentation. Severe diffuse non-scarring alopecia was linked to hematologic and renal involvement, suggesting active disease. The study concluded that trichoscopy is a valuable diagnostic and monitoring tool for SLE, with severe diffuse non-scarring alopecia potentially indicating active disease and organ involvement. However, the study was limited by its cross-sectional design, single-center setting, focus on Southeast Asians, and lack of long-term follow-up.